| NPI | 1912640350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON LEE BROWN PIC 678-434-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-11-28 |